Objectives: To determine the association
between hyperkyphotic (bent-forwards)
posture and rate of mortality and
cause-specific mortality in older
persons.

Participants: Subjects were 1,353
participants from the Rancho Bernardo
Study who had measurements of kyphotic
posture made at an osteoporosis visit
between 1988 and 1991.

Participants were followed for an
average of 4.2 years, with mortality and
cause of death confirmed using review of
death certificates.

Hyperkyphotic posture, was more common
in men than women (44% in men, 22% of
women). In age- and sex-adjusted
analyses, persons with hyperkyphotic
posture had a 1.44 greater rate of
mortality. In multiply adjusted models,
the increased rate of death associated
with hyperkyphotic posture remained
significant (relative hazard=1.40). In
cause-specific mortality analyses,
hyperkyphotic posture was specifically
associated with an increased rate of
death due to atherosclerosis.

Conclusion: Older men and women with
hyperkyphotic posture have higher
mortality rates.

NICK’S FOOTNOTE:
This is scary. This suggest that bad
posture means you are probably going to
die younger than you should. So, improve
your posture now before it is too late.

Spinal Kyphosis Causes Demyelination and
Neuronal Loss in the Spinal Cord: A New
Model of Kyphotic Deformity Using
Juvenile Japanese Small Game Fowls.

Study Design. Histologic changes in the
spinal cord caused by progressive spinal
kyphosis were assessed using a new
animal model.

Objectives. To evaluate the effects of
chronic compression associated with
kyphotic deformity of the cervical spine
on the spinal cord.

Summary of Background Data. The spinal
cord has remarkable ability to resist
chronic compression, however, delayed
paralysis is sometimes seen following
the development of spinal kyphosis.

Results. There was a significant
correlation between the kyphotic angle
and the degree of spinal cord
flattening. The spinal cord was
compressed most intensely at the apex of
the kyphosis, where demyelination of the
anterior funiculus as well as neuronal
loss and atrophy of the anterior horn
were observed. Demyelination progressed
as the kyphotic deformity became more
severe, initially affecting the anterior
funiculus and later extending to the
lateral and then the posterior
funiculus. Angiography revealed a
decrease of the vascular distribution at
the ventral side of the compressed
spinal cord.

Conclusions. Progressive kyphosis of the
cervical spine resulted in demyelination
of nerve fibers in the funiculi and
neuronal loss in the anterior horn due
to chronic compression of the spinal
cord. These histologic changes seem to
be associated with both continuous
mechanical compression and vascular
changes in the spinal cord.

NICK’S FOOTNOTE:
Lots of big words. But this may explain
the first study discussed: Bottom line,
as the spine curves forward (as in bad
posture) the nerve tissue in the spinal
cord begins to decay. I’d rather have
good posture and healthy nerves thanks.

The effects of upright and slumped
postures on the recall of positive and
negative thoughts.

This study assessed whether it was
easier to generate positive and negative
thoughts in either an upright or slumped
position. Twenty-four participants, who
reported no clinical depression or
anxiety, completed the Tellegen
absorption questionnaire and a
self-assessment of imagery ability.
Surface electromyography (sEMG) of
zygomaticus major, heart rate, and
respiratory rate were assessed across
four 1-min counterbalanced conditions of
either upright or slumped posture and
either positive or negative thought
generation. Posttrial checks of
compliance were completed. At the end of
the study, participants rated which
thought was easiest to generate in the
two postures. Significantly more
participants (22), or 92%, indicated it
was easiest to generate positive
thoughts in the upright position. ANOVA
of sEMG activity significantly
distinguished positive and negative
thoughts in both positions. Significant
correlation coefficients were observed
between scores on the Tellegen scale of
absorption and the ability to generate
thoughts quickly and between
self-perceptions of imagery ability with
the maintenance of thoughts across time.
This study supports the finding that
positive thoughts are more easily
recalled in the upright posture.

NICK’S FOOTNOTE:
PowerPosture program claims that
it will make you look and feel more
confident, and improve concentration and
thinking ability. This paper provides
evidence as to how this is possible. Try
it yourself.

The representation of self reported
affect in body posture and body posture
simulation.

It is taken for granted that the
non-verbal information we acquire from a
person's body posture and position
affects our perception of others.
However, to date human postures have
never been described on an empirical
level. This study is the first approach
to tackle the unexplored topic of human
postures. We combined two approaches:
traditional behavior observation and
modern anthropometric analysis.
Photographs of 100 participants were
taken, their body postures were
transferred to a three dimensional
virtual environment and the occurring
body angles were measured. The
participants were asked to fill in a
questionnaire about their current
affective state. A principal component
analysis with the items of the affect
questionnaire (Positive Negative Affect
Scales, PANAS) revealed five main
factors: aversion, openness, irritation,
happiness, and self-confidence. The body
angles were then regressed on these
factors and the respective postures were
reconstructed within a virtual
environment. 50 different subjects rated
the reconstructed postures from the
positive and negative end of the
regression. We found the ratings to be
valid and accurate in respect to the
five factors.

NICK’S FOOTNOTE:
They say the eyes are the window to the
soul. I say that your posture is the
window to your mind. Good posture
reflects and encourages good mind stuff,
while bad posture exposes and
predisposes to bad mind stuff.

RESULTS: The severity of FP was
classified as mild in 11, moderate in
28, and severe in 21 patients. Although
there were no differences between FP
groups on the skeletal fragility
measurements, the moderate and severe FP
groups were significantly different from
the mild FP group for greater pain at
the level of the cervical and lumbar
spine. The severe FP group was also
significantly different from the mild
but not the moderate FP group in the
following categories: clinical profile
(greater depression, reduced
motivation), muscle impairment (weaker
spine extensor, ankle plantarflexor, and
dorsiflexor muscles; shorter pectoralis
and hip flexor muscles), the motor
function performance-based tests (lower
scores in the balance and gait subsets
of the Performance Oriented Mobility
Assessment), the instrumented gait
analysis (slower and wider base of
support), and disability (lower score on
the Nottingham Extended Activities of
Daily Living Index). The total number of
vertebral fractures was not associated
with differences in severity of FP,
demographic and anthropometric
characteristics, clinical profile,
muscular function, performance-based and
instrumental measures of motor function,
and disability, but it was associated
with reduced proximal femur and lumbar
spine BMD.

CONCLUSION: The severity of FP in
elderly female patients (without
apparent comorbid conditions) is related
to the severity of vertebral pain,
emotional status, muscular impairments,
and motor function but not to
osteoporosis, and FP has a measurable
effect on disability. In contrast, the
presence of vertebral fractures in
patients with FP is associated with
lower BMD but not patients' clinical and
functional status. Therefore, FP, back
pain, and mobility problems can occur
without osteoporosis. Older women with
FP and vertebral pain may be candidates
for rehabilitation interventions that
address muscular impairments, posture,
and behavior modification. Randomized
controlled trials are needed to support
these conclusions

NICK’S FOOTNOTE:
This study should be as convincing as
the first. Learn, develop and maintain
good posture and you are setting
yourself up for greater quality of life
in the years to come. Ignore and neglect
your bad posture at your own peril.

Trigger points in the suboccipital
muscles and forward head posture in
tension-type headache.

OBJECTIVE: To assess the presence of
trigger points (TrPs) in the
suboccipital muscles and forward head
posture (FHP) in subjects with chronic
tension-type headache (CTTH) and in
healthy subjects, and to evaluate the
relationship of TrPs and FHP with
headache intensity, duration, and
frequency.

METHODS: Twenty CTTH subjects and 20
matched controls without headache
participated. TrPs were identified by
eliciting referred pain with palpation,
and increased referred pain with muscle
contraction. Side-view pictures of each
subject were taken in sitting and
standing positions, in order to assess
FHP by measuring the craniovertebral
angle. Both measures were taken by a
blinded assessor. A headache diary was
kept for 4 weeks in order to assess
headache intensity, frequency, and
duration.

RESULTS: Sixty-five percent (13/20) CTTH
subjects showed active TrPs and 35%
(7/20) had latent TrPs in the
suboccipital muscles. Six (30%) controls
also had latent TrPs. Differences in the
presence of suboccipital muscle TrPs
between both the groups were significant
for active TrPs but not for latent TrPs.
CTTH subjects with active TrPs reported
a greater headache intensity and
frequency than those with latent TrPs.
The degree of FHP was greater in CTTH
subjects than in controls in both
sitting and standing positions. Within
the CTTH group, there was a negative
correlation between the craniovertebral
angle and the frequency of headache, in
sitting position, in standing position).
CTTH subjects with active TrPs had a
greater FHP than those with latent TrPs,
though this difference was not
significant.

CONCLUSIONS: Suboccipital active TrPs
and FHP were associated with CTTH. CCTH
subjects with active TrPs reported a
greater headache intensity and frequency
than those with latent TrPs. The degree
of FHP correlated positively with
headache duration, headache frequency,
and the presence of suboccipital active
TrPs.

NICK’S FOOTNOTE:
I have to confess that occasionally I
have had headache suffering clients who
only get temporary relief, from their
headaches. Not everyone gets the wonder
cure that they (and I) were hoping for.
But I have found that if these clients
also complete the
PowerPosture program that their
results are massively improved as this
study would support.

OBJECTIVES: To evaluate shoulder
position in asthmatics and its
correlation to the peak expiratory flow
rate (PEFR).

METHODS: A cross-sectional study
involving 19 asthmatics (study group)
and 20 healthy volunteers (control
group). Assessment of PEFR was used to
determine airway obstruction. Shoulder
position was quantified as the ratio
between the front and back measurements,
in centimeters, of the distance between
the two outermost points of each
scapula. Shoulder position measurement (SPM)
ratio data from both groups were
compared and correlated to PEFR.

CONCLUSION: Determining SPM ratios
allowed us to identify those postural
alterations that correlated with
pulmonary function in asthmatics and in
healthy individuals. Further
investigation is needed before SPM can
be used as a tool for clinical
evaluation of asthma patients.

NICK’S FOOTNOTE:
Once again there is a clear correlation
between bad posture and an reduction of
an important internal function – lung
capacity.

OBJECTIVE: To test the construct
validity of postural backache. To
identify if individuals with backache
sit for longer periods of sustained
sitting and have more flexed relaxed
sitting posture than individuals in a no
backache group.

METHODS: Following an initial
questionnaire, student volunteers
without a history of 'serious' back pain
were classified as either postural
backache group or no backache group.
With the use of an activity diary that
plotted activity every 5 minutes over a
3-day period, the average time spent in
different postures was established.
Relaxed sitting posture was evaluated
using Dartfish software to analyze
videotape after 10 minutes of sitting.

RESULTS: The most common daytime
activity of both groups was sitting,
with average sitting time not
significantly different between groups.
Periods of uninterrupted sustained
sitting and uninterrupted sustained
studying were significantly longer, and
the degree of flexion in relaxed sitting
was significantly greater in the
postural backache group.

CONCLUSION: In a group of student
volunteers, half reported postural
backache. The group with backache sat
for longer periods without interruption
and had a more flexed relaxed sitting
posture than the no backache group.
These findings appear to validate
McKenzie's concept of a postural
syndrome.

NICK’S FOOTNOTE:
I’ve often told people who suffer with
backache after sitting, that how they
sit is more important than what they sit
on. Bad posture can turn the best and
most expensive ergonomic chair into a
painful experience. If your work
involves extended periods of sitting
then it is vital to complete the
PowerPosture program.

Determining the Relationship Between
Cervical Lordosis and Neck Complaints.

Objective: To investigate the presence
of a “functionally normal” cervical
lordosis and identify if this and the
amount of forward head posture are
related to neck complaints.

Results: Patients with lordosis of 20°
or less were more likely to have
cervicogenic symptoms. The association
between cervical pain and lordosis of 0°
or less was significant. The odds that a
patient with cervical pain had a
lordosis of 0° or less was 18 times
greater than for a patient with a
non-cervical complaint. Patients with
cervical pain had less lordosis and this
was consistent over all age ranges.
Males had larger median cervical
lordosis than females (20° vs 14°). When
partitioned by age grouping, this trend
is significant only in the 40- to
49-year-old range.

Conclusion: We found a statistically
significant association between cervical
pain and lordosis <20° and a “clinically
normal” range for cervical lordosis of
31° to 40°. Maintenance of a lordosis in
the range of 31° to 40° could be a
clinical goal for chiropractic
treatment.

NICK’S FOOTNOTE:
Pretty convincing evidence that
achieving and maintaining good neck
posture helps to minimise the risk of
neck problems

Cervical Kyphosis is a Possible Link to
Attention-deficit/hyperactivity
Disorder.

OBJECTIVE: To discuss the case of a
patient who was diagnosed with
attention-deficit/hyperactivity disorder
(ADHD) by a general practitioner and was
treated with chiropractic care.

CLINICAL FEATURES: A 5-year-old patient
was diagnosed with ADHD and treated by a
pediatrician unsuccessfully with
methylphenidate (Ritalin), Adderall, and
Haldol for 3 years. The patient received
35 chiropractic treatments during the
course of 8 weeks. A change from a 12
degrees C2-7 kyphosis to a 32 degrees
C2-7 lordosis was observed after
treatment. During chiropractic care, the
child's facial tics resolved and his
behaviour vastly improved. After 27
chiropractic visits, the child's
pediatrician stated that the child no
longer exhibited symptoms of ADHD. The
changes in structure and function may be
related to the correction of cervical
kyphosis.

CONCLUSION: The patient experienced
significant reduction in symptoms.
Additionally, the medical doctor
concluded that the reduction in symptoms
was significant enough to discontinue
the medication. There may be a possible
connection that correction of cervical
kyphosis in patients with ADHD may
produce a desirable clinical outcome.

NICK’S FOOTNOTE:
How can this be? ADHD is seen as a brain
disorder, and yet this child’s ADHD was
significantly improved by improvement in
neck posture and alignment. Could be
that a healthy brain requires a healthy
neck.

OBJECTIVE: To investigate whether a
statistical correlation exists between
lateral cervical geometry and cervical
pathology, as identified on neutral
anteroposterior (AP) and lateral
radiographs within a symptomatic group;
describe the cervical pathology and
determine its location and frequency;
and identify the subject's age, sex, and
chief complaint.

CONCLUSION: We identified 5 geometric
variables from the lateral cervical
spine that were predictive 79% of the
time for cervical degenerative joint
disease. There were discrete age, sex,
and symptom groups, which demonstrated
an increased incidence of degenerative
joint disease.

NICK’S FOOTNOTE:
Want an arthritic neck as you grow
older? Then ignore your head and neck
posture and continue to live a slouched
lifestyle: Or, work toward great posture
and take preventative steps to avoiding
a rusty neck.

Effects of abnormal posture on capsular
ligament elongations in a computational
model subjected to whiplash loading.

Abnormal postures increased elongation
magnitudes in these regions by up to
70%. Excessive ligament elongations
induce laxity to the facet joint,
particularly at the local regions of the
anatomy in the abnormal kyphotic
posture. Increased laxity may predispose
the cervical spine to accelerated
degenerative changes over time and lead
to instability. Results from the present
study, while providing quantified level-
and region-specific kinematic data,
concur with clinical findings that
abnormal spinal curvatures enhance the
likelihood of whiplash injury and may
have long-term clinical and
biomechanical implications.

NICK’S FOOTNOTE:

Wait a
minute... Most argue that whiplash leads
to increased forward head posture? Now
we see evidence suggesting that having
forward head posture increases the
chance of suffering from a whiplash
injury. That is, if you have good
posture, an accident is less likely to
create an injury that's going to give
you long term problems... Bring on good
posture!

“Observations of the striking influence
of postural mechanics on function and
symptomatology have led to our
hypothesis that posture affects and
moderates every physiologic function
from breathing to hormonal production.
Spinal pain, headache, mood, blood
pressure, pulse, and lung capacity are
among the functions most easily
influenced by posture.”

NICK’S FOOTNOTE:
Couldn't have summed it up better
myself!

The Neurochemically Diverse
Intermedius Nucleus of the Medulla as a
Source of Excitatory and Inhibitory
Synaptic Input to the Nucleus Tractus
Solitarii

Sensory afferent signals
from neck muscles have been postulatedto influence central
cardiorespiratory control as componentsof postural reflexes, but neuronal
pathways for this actionhave
not been identified... Projections from
the InM to the nucleus tractus
solitarius (NTS)were studied
electrophysiologically in rat brainstem
slices.Electrical
stimulation of the NTS resulted in
antidromicallyactivated
action potentials within InM neurons...
Thus, the InM contains neurochemicallydiverse neurons and sends both
excitatory and inhibitory projectionsto the NTS. These data provide a
novel pathway that may underliepossible reflex changes in
autonomic variables after neck musclespindle afferent activation.

NICK’S FOOTNOTE:
"IN OTHER WORDS" - When your posture is
bad nerve endings in the muscles of your
neck fire-up and can stimulate the part
of your nervous system that controls
even the heart and the lungs...